Communication among team members on a critical care unit is integrally linked to patient safety. When the critical care unit at Chambersburg Hospital (Chambersburg, Pennsylvania) moved into the new wing in December 2012, it became apparent that the new layout was less conducive to facilitating staff interactions than the old layout had been. The team needed to adapt to preserve patient safety.

The prior unit was designed with a hub-and-spokes layout. Nurses congregated in the central nursing station to view the cardiac monitors, document, and obtain medications, enabling constant interactions. The new critical care unit was constructed in a horseshoe arrangement, with small working pods between each pair of patients’ rooms—complete with computers for documentation and medication drawers. Nurses were encouraged to stay in their “pods” to remain closer to their patients.

Although this new design improved the environment for patients, critical care staff began struggling with open communication....

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